We’ve established that if a tooth is symptomatic and infected, an antibiotic needs to be given in order to calm the tooth down, so that it can be ‘worked’ on, otherwise it won’t freeze (numb) properly.

Most of the time, the patient thinks that an antibiotic in itself, is enough to treat the symptomatic tooth. But actually, it is only when the antibiotic has gotten in to your system (which is at least 24 hours), that the treatment can begin. What do we do with our infected tooth? The pulp (nerve) is infected, so it needs to be removed via a root canal treatment. You can read all about this procedure in the next entry.

If the infected nerve is not cleaned out, then the nerve and blood vessels within it die, causing the pulp to become gangrenous and a dental abscess results. Pressure builds up in the pulp chamber due to the gangrenous tissues and the blood supply to the pulp is cut off. If the blood supply is compromised, then antibiotics are prevented from getting into the pulp and helping the tooth to calm down. The only treatment is to physically remove the dead tissue via the root canal treatment.

Extreme Cases At times, if an abscess gets too large, it can spread upwards to the eye, in the case of an upper tooth, and below the jaw line if it’s a lower one. If this happens, the patient NEEDS to go to the hospital A.S.A.P to have an Intravenous placed so an antibiotic can get in to the patients system immediately, as opposed to the oral route which can take up to 24 hours to take effect.

In extreme cases, severe swellings have resulted in blindness when an upper tooth is involved or a septicemia (infection of the blood) when it is a lower tooth. Facial swellings are not something that should be taken lightly.

The next step for the tooth is a root canal. Stay tuned for more in our next entry.

A Brampton Dentist practicing for more than 23 years, Dr. Robert Axelrad has owned and managed his own dental practice since 1997. Affectionately known by his patients as Brampton’s Gentle Dentist, he moved his practice to its current, state-of-the-art dental office in Brampton, Ontario in 2002 to accommodate his growing list of happy patients.